Provider Demographics
NPI:1679236137
Name:ROZZI, MATTHEW R (PHD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:R
Last Name:ROZZI
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3902 MILWAUKEE ST UNIT 7002
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53707-5002
Mailing Address - Country:US
Mailing Address - Phone:608-602-8883
Mailing Address - Fax:
Practice Address - Street 1:3902 MILWAUKEE ST UNIT 7002
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53707-5002
Practice Address - Country:US
Practice Address - Phone:608-602-8883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-20
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3994-57103TC1900X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling